A review of the latest insights into the mechanism of action of strontium in bone

A review of the latest insights into the mechanism of action of strontium in bone

Interest in strontium (Sr) has persisted over the last three decades due to its unique mechanism of action: it simultaneously promotes osteoblast function and inhibits osteoclast function. While this mechanism of action is strongly supported by in vitro studies and small animal trials, recent large-...

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Published in:Bone Reports Vol. 12; p. 100273
Main Authors: Marx, Daniella, Rahimnejad Yazdi, Alireza, Papini, Marcello, Towler, Mark
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-06-2020
Elsevier
Subjects:
Bone
Mechanism of action
Medicine
Physiology
Strontium
Strontium
Medicine
Physiology
Bone
Mechanism of action
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Abstract Interest in strontium (Sr) has persisted over the last three decades due to its unique mechanism of action: it simultaneously promotes osteoblast function and inhibits osteoclast function. While this mechanism of action is strongly supported by in vitro studies and small animal trials, recent large-scale clinical trials have demonstrated that orally administered strontium ranelate (SrRan) may have no anabolic effect on bone formation in humans. Yet, there is a strong correlation between Sr accumulation in bone and reduced fracture risk in post-menopausal women, suggesting Sr acts via a purely physiochemical mechanism to enhance bone strength. Conversely, the local administration of Sr with the use of modified biomaterials has been shown to enhance bone growth, osseointegration and bone healing at the bone-implant interface, to a greater degree than Sr-free materials. This review summarizes current knowledge of the main cellular and physiochemical mechanisms that underly Sr’s effect in bone, which center around Sr’s similarity to calcium (Ca). We will also summarize the main controversies in Sr research which cast doubt on the ‘dual-acting mechanism’. Lastly, we will explore the effects of Sr-modified bone-implant materials both in vitro and in vivo, examining whether Sr may act via an alternate mechanism when administered locally.
AbstractList Interest in strontium (Sr) has persisted over the last three decades due to its unique mechanism of action: it simultaneously promotes osteoblast function and inhibits osteoclast function. While this mechanism of action is strongly supported by in vitro studies and small animal trials, recent large-scale clinical trials have demonstrated that orally administered strontium ranelate (SrRan) may have no anabolic effect on bone formation in humans. Yet, there is a strong correlation between Sr accumulation in bone and reduced fracture risk in post-menopausal women, suggesting Sr acts via a purely physiochemical mechanism to enhance bone strength. Conversely, the local administration of Sr with the use of modified biomaterials has been shown to enhance bone growth, osseointegration and bone healing at the bone-implant interface, to a greater degree than Sr-free materials. This review summarizes current knowledge of the main cellular and physiochemical mechanisms that underly Sr’s effect in bone, which center around Sr’s similarity to calcium (Ca). We will also summarize the main controversies in Sr research which cast doubt on the ‘dual-acting mechanism’. Lastly, we will explore the effects of Sr-modified bone-implant materials both in vitro and in vivo, examining whether Sr may act via an alternate mechanism when administered locally.
Interest in strontium (Sr) has persisted over the last three decades due to its unique mechanism of action: it simultaneously promotes osteoblast function and inhibits osteoclast function. While this mechanism of action is strongly supported by studies and small animal trials, recent large-scale clinical trials have demonstrated that orally administered strontium ranelate (SrRan) may have no anabolic effect on bone formation in humans. Yet, there is a strong correlation between Sr accumulation in bone and reduced fracture risk in post-menopausal women, suggesting Sr acts a purely physiochemical mechanism to enhance bone strength. Conversely, the local administration of Sr with the use of modified biomaterials has been shown to enhance bone growth, osseointegration and bone healing at the bone-implant interface, to a greater degree than Sr-free materials. This review summarizes current knowledge of the main cellular and physiochemical mechanisms that underly Sr's effect in bone, which center around Sr's similarity to calcium (Ca). We will also summarize the main controversies in Sr research which cast doubt on the 'dual-acting mechanism'. Lastly, we will explore the effects of Sr-modified bone-implant materials both and , examining whether Sr may act an alternate mechanism when administered locally.
Interest in strontium (Sr) has persisted over the last three decades due to its unique mechanism of action: it simultaneously promotes osteoblast function and inhibits osteoclast function. While this mechanism of action is strongly supported by in vitro studies and small animal trials, recent large-scale clinical trials have demonstrated that orally administered strontium ranelate (SrRan) may have no anabolic effect on bone formation in humans. Yet, there is a strong correlation between Sr accumulation in bone and reduced fracture risk in post-menopausal women, suggesting Sr acts via a purely physiochemical mechanism to enhance bone strength. Conversely, the local administration of Sr with the use of modified biomaterials has been shown to enhance bone growth, osseointegration and bone healing at the bone-implant interface, to a greater degree than Sr-free materials. This review summarizes current knowledge of the main cellular and physiochemical mechanisms that underly Sr’s effect in bone, which center around Sr’s similarity to calcium (Ca). We will also summarize the main controversies in Sr research which cast doubt on the ‘dual-acting mechanism’. Lastly, we will explore the effects of Sr-modified bone-implant materials both in vitro and in vivo , examining whether Sr may act via an alternate mechanism when administered locally.
ArticleNumber 100273
Author Rahimnejad Yazdi, Alireza
Papini, Marcello
Towler, Mark
Marx, Daniella
Author_xml – sequence: 1
  givenname: Daniella
  surname: Marx
  fullname: Marx, Daniella
  organization: Department of Biomedical Engineering, Ryerson University, Toronto M5B 2K3, Ontario, Canada
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  givenname: Alireza
  surname: Rahimnejad Yazdi
  fullname: Rahimnejad Yazdi, Alireza
  organization: Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto M5B 1W8, Ontario, Canada
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  surname: Papini
  fullname: Papini, Marcello
  organization: Department of Biomedical Engineering, Ryerson University, Toronto M5B 2K3, Ontario, Canada
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  givenname: Mark
  surname: Towler
  fullname: Towler, Mark
  email: mtowler@ryerson.ca
  organization: Department of Biomedical Engineering, Ryerson University, Toronto M5B 2K3, Ontario, Canada
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Keywords Strontium
Medicine
Physiology
Bone
Mechanism of action
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SubjectTerms Bone
Mechanism of action
Medicine
Physiology
Strontium
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Title A review of the latest insights into the mechanism of action of strontium in bone
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